| NPI | 1639580186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNICA MUMFORD MUMFORD CEO 912-844-6497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA RN168735) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: GA RN168735) |
| 251K00000X Public Health or Welfare (Licence: GA RN168735) | |
| 252Y00000X Early Intervention Provider Agency (Licence: GA RN168735) | |
| 253Z00000X In Home Supportive Care (Licence: GA RN168735) | |
| 261QR1300X Clinic/Center, Rural Health (Licence: GA RN168735) | |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2014-05-17 |