| NPI | 1225207988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN MARIE JACKSON Certified Nurses Assistant 843-870-1839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: SC 120514E) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: SC 120514E) |
| 376K00000X Nurse's Aide (Licence: SC 120514E) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |