| NPI | 1629626403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYTEILA MORDRIA ROACH Owner/CEO 228-265-0331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-02-25 |