| NPI | 1790394161 |
|---|---|
| Doing Business As | MODERN VINTAGE HOME CARE |
| Entity Type | Organization |
| Authorized Contact | DEREK WAYNE THOMPSON Owner/Managing Director 832-886-6717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2021-05-06 |