| NPI | 1700019486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OCTAVIA DEVONNE SHANKLE Owner/Director 980-207-3947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: NC 100027) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2019-08-01 |