| NPI | 1417737271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA DIANE BRUNSON Administrator 267-251-0828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-09-29 |