| NPI | 1659616985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICO A WAGNER Director 336-471-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2013-07-08 |