| NPI | 1528740503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHEN HOUSTON Managing Member 346-339-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 251S00000X |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2023-09-08 |