| NPI | 1750757035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LYNN DAVIS Owner 304-257-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 261QA0600X Clinic/Center Adult Day Care (Licence: WV 23198575) |
| 253Z00000X In Home Supportive Care (Licence: WV 23198575) | |
| 251B00000X Case Management (Licence: WV 23198575) | |
| 251J00000X Nursing Care (Licence: WV 23198575) | |
| 385H00000X Respite Care (Licence: WV 23198575) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-05-04 |