| NPI | 1578276135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA JOHNSON Owner 704-625-6598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X Community/Behavioral Health | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 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 | 2022-12-28 |
| Last Update Date | 2023-09-14 |