| NPI | 1770932915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KAY KING Manager 602-001-4072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: IN 16-013923-1) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2019-02-04 |