| NPI | 1215698527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTELLE HENDERSON Owner 773-956-4603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2022-01-08 |
| Last Update Date | 2022-01-08 |