| NPI | 1659931442 |
|---|---|
| Former Legal Business Name | NICOLE RIDEOUT |
| Entity Type | Organization |
| Authorized Contact | NICOLE RIDEOUT Owner 443-900-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2019-06-14 |