| NPI | 1366057812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADNIKE IYABO BANTALE Administrator 909-319-8104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2021-02-10 |