| NPI | 1750944336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONNE DOUMASSY Owner 469-557-1322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Additional Taxonomies | 251E00000X Home Health |
| 251G00000X Hospice Care, Community Based | |
| 251J00000X Nursing Care | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |