| NPI | 1255801114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY GREEN Owner 210-701-4806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2021-08-27 |