| NPI | 1417578667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STARNISHA BURNETTE Director 877-277-8453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 385H00000X Respite Care |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| 347C00000X Private Vehicle | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2023-04-05 |