| NPI | 1699467902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMEON MBENKUM Administrator/Owner 806-620-2696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 251J00000X Nursing Care | |
| 3747A0650X Technician, Attendant Care Provider | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |