| NPI | 1306470497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUADEERAH CAMPBELL Administrator 862-223-8957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251X00000X |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 347C00000X Private Vehicle | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2021-02-17 |