| NPI | 1760053441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATORIA CLARK-JACKSON Owner/Mgr 813-606-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2021-07-05 |