| NPI | 1215773577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANINGBE FOFANA Registered Nurse/ Administrator 317-789-6127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2024-07-06 |
| Last Update Date | 2024-07-06 |