| NPI | 1740040450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTA BRUNSON Owner 219-614-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-26 |