| NPI | 1760229926 |
|---|---|
| Former Legal Business Name | FATSAL SPECTACLE LLC |
| Entity Type | Organization |
| Authorized Contact | BOLAJI SALAHUDEEN IMAM Managing Director 317-222-0274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2024-07-13 |
| Last Update Date | 2024-07-13 |