| NPI | 1265313936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY M CROWDER Provider 346-404-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |