| NPI | 1285390716 |
|---|---|
| Doing Business As | HIAWATHA PRIVATE HEALTHCARE SERVICE, LLC |
| Entity Type | Organization |
| Authorized Contact | HIAWATHA VENNESSA RAINEY Administrator 706-306-0091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2024-06-20 |