| NPI | 1790566032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE J MARTIN Owner 937-926-0069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |