| NPI | 1639991268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALTON BETHEA Director 984-354-1778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2024-10-25 |