| NPI | 1396626842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIYONNA BLACKMON Owner 314-410-9117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |