| NPI | 1245066380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JETER Owner 708-243-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-13 |