| NPI | 1801560768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FULLER Owner 731-358-4062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 251E00000X Home Health |
| 261QC1500X Clinic/Center, Community Health | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| 302R00000X Health Maintenance Organization | |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-04 |