| NPI | 1518578251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK DWAYNE JACKSON Administrator 310-999-8113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WH0200X Registered Nurse, Home Health |
| Additional Taxonomies | 163WH1000X Registered Nurse, Hospice |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-08-16 |