| NPI | 1467838995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN JOSEPH BOUDREAUX Owner 228-207-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2015-08-06 |