| NPI | 1699570267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY WALLACE CEO 980-505-4686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-20 |