| NPI | 1770274904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Provider Enrollment Manager 502-560-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-07-11 |