| NPI | 1235707506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY P BONGAM Member 786-451-5184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-10-25 |