| NPI | 1285407163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKALA FOMOND Administrator 224-548-0927 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2023-11-15 |