| NPI | 1578059739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS TYSON Administrator 407-925-7237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: FL 235270) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN2529832) |
| 3747P1801X Technician, Personal Care Attendant | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 0700506) | |
| 372600000X Adult Companion (Licence: FL 235270) | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2018-07-10 |