| NPI | 1356904783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLERMINE BROOKINS Owner 772-203-9793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health | |
| 253Z00000X In Home Supportive Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2020-08-19 |