| NPI | 1578127536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATARSHA NICOLE THOMAS Owner/Operator 904-297-8877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2021-12-02 |