| NPI | 1578273959 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | ALICIA GOLLIDAY Administrator 618-581-0799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-11-28 |