| NPI | 1487135620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY MICHELLE KING Owner 386-315-1260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 164W00000X Licensed Practical Nurse | |
| 251E00000X Home Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 314000000X Skilled Nursing Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-08-26 |
| Last Update Date | 2024-07-29 |