| NPI | 1285001941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE JOHNSON Owner/Operator 662-605-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2017-01-27 |