| NPI | 1790472298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LUCKETT Director 662-408-6995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-08-25 |