| NPI | 1700692621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFINY MACK Owner 220-238-9034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-06 |