| NPI | 1821878968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIA HART Owner 904-312-0318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |