| NPI | 1336702612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASTITY CORDOVA-HEYWARD President 866-728-1346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-06-11 |