| NPI | 1245656578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATARSHA CRUMPLER Director 984-278-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251T00000X PACE Provider Organization |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 251J00000X Nursing Care | |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2025-09-10 |