| NPI | 1811621733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYSHELL GARDNER Owner 757-777-0032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2024-02-15 |