| NPI | 1568974863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTELLA WILKES Owner 864-308-8712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 291U00000X Clinical Medical Laboratory | |
| 302R00000X Health Maintenance Organization | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2022-08-16 |