| NPI | 1427936483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENISHA YVONNE BIBBS Owner 678-522-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 253Z00000X In Home Supportive Care | |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |