| NPI | 1538671896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WHOBREY Provider Enrollment 502-630-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician Personal Care Attendant |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2021-10-19 |