| NPI | 1578150462 |
|---|---|
| Former Legal Business Name | HIS SHADOW SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | EZE OWUNNA Administration 432-305-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-12-24 |
| Last Update Date | 2020-12-24 |