| NPI | 1346047149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZALIA PETTWAY Owner 443-403-9597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 302F00000X Exclusive Provider Organization | |
| 305R00000X Preferred Provider Organization | |
| 385H00000X Respite Care | |
| 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 | 2025-02-27 |
| Last Update Date | 2025-02-27 |