| NPI | 1679370340 |
|---|---|
| Former Legal Business Name | AWESOME INNOVATIVE SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | CHARLEY WOODBERRY Owner 718-865-6168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-02-28 |