| NPI | 1235264375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA M MOMENT Owner Agent 904-704-4764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747A0650X Technician, Attendant Care Provider (Licence: FL 228941) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |