| NPI | 1679030704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIAZIZ OMAR HUSSEIN Administrator 571-277-0173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |