| NPI | 1497345243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHABLIS SHAW Office Administrator 984-244-9405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-01-26 |