| NPI | 1376475491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELL WALKINE Owner 772-200-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-06-02 |
| Last Update Date | 2026-06-02 |