| NPI | 1649666876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL WORTHINGTON Representative 336-965-0153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC 263875) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: NC 263875) |
| 252Y00000X Early Intervention Provider Agency (Licence: NC 263875) | |
| 253J00000X Foster Care Agency (Licence: NC 263875) | |
| 253Z00000X In Home Supportive Care (Licence: NC 263875) | |
| 283X00000X Rehabilitation Hospital (Licence: NC 263875) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: NC 263875) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |