| NPI | 1649983016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMANE GRANT Board President 833-469-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2023-05-18 |