| NPI | 1376221713 |
|---|---|
| Doing Business As | PHENOMENAL CARE SERVICES |
| Entity Type | Organization |
| Authorized Contact | DARRYL WAYNE PETERSON CEO 234-521-1318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 347C00000X Private Vehicle |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-07-06 |