| NPI | 1629719729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANACE ISAAC President/CEO 904-293-5395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 251E00000X Home Health | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |