| NPI | 1336956911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA TRACEE JOHNSON Owner 704-241-0788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 253J00000X Foster Care Agency | |
| 253Z00000X In Home Supportive Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2025-01-21 |