| NPI | 1417712555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WIGFALL CEO 980-721-1573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QH0700X Clinic/Center Hearing and Speech | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |