| NPI | 1710633920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NSEMBOOWO ENYONG Administrator 138-205-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251J00000X Nursing Care |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2023-05-01 |