| NPI | 1750668513 |
|---|---|
| Other Name | RWW MOUNTAIN LAKE |
| Entity Type | Organization |
| Authorized Contact | HEATHER WILSON National Credentialing Manager 502-272-3463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2022-03-30 |