| NPI | 1689390726 |
|---|---|
| Former Legal Business Name | PERTINA HUMPHREY |
| Entity Type | Organization |
| Authorized Contact | PERTINA HUMPHREY Adminstrator 317-985-5134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-11-03 |