| NPI | 1669334652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIQELL BOGA CEO 870-739-0664 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 163WH1000X Registered Nurse, Hospice | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-11-26 |
| Last Update Date | 2025-11-26 |