| NPI | 1457629990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA DENISE BENNETT Owner 334-559-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA CSW003190) |
| Additional Taxonomies | 251B00000X Case Management (Licence: AL 4484B) |
| 251B00000X Case Management (Licence: GA CSW003190) | |
| 251S00000X (Licence: AL 4484B) | |
| 253Z00000X In Home Supportive Care (Licence: AL 4484B) | |
| 253Z00000X In Home Supportive Care (Licence: GA CSW003190) | |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |