| NPI | 1699499798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA CLARK CEO 567-702-1078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |