| NPI | 1376816702 |
|---|---|
| Doing Business As | 111HOME PERSONAL CARE AGENCY |
| Entity Type | Organization |
| Authorized Contact | LAVERN I SUGGS CEO 574-350-9831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: IN 11-012725-1) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |