| NPI | 1770241911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANTA SACCOH Owner/President/Admin 302-203-6828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2021-12-06 |