| NPI | 1497373716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVONIA STACKHOUSE Owner/Clinical Administrator 443-941-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |