| NPI | 1700602232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERLEE JOHNSON Doo 330-990-2775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2024-11-30 |
| Last Update Date | 2024-11-30 |