| NPI | 1790436061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY JOANN JOHNSON Owner 948-212-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2025-04-01 |