| NPI | 1255099636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN BACON FAIRBANKS Owner 904-537-6722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2021-12-02 |