| NPI | 1598133266 |
|---|---|
| Doing Business As | JOHNICKIE SPAHOUSE |
| Entity Type | Organization |
| Authorized Contact | POMDREST J HENRY Owner 678-733-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 251E00000X Home Health |
| 385H00000X Respite Care | |
| 251G00000X Hospice Care, Community Based | |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2016-01-05 |