| NPI | 1578433892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTINY COUNTRYMAN Owner 510-424-4255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health | |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2025-11-11 |