NPI | 1639341993 |
---|---|
Entity Type | Organization |
Authorized Contact | LORA BOOZELL Owner 815-505-4463 |
Organization Subpart ? | No |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL 146005242) |
Additional Taxonomies | 251E00000X Home Health (Licence: IL 146005242) |
Enumeration Date | 2008-03-27 |
Last Update Date | 2008-03-27 |