| NPI | 1518497114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMILLIA KASANDRA JEFFERIES CEO 239-600-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QH0100X Clinic/Center, Health Services | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311Z00000X Custodial Care Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 315D00000X Hospice, Inpatient | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |