| NPI | 1720779192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUOYA JACKSON CEO 810-406-9536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2025-11-10 |