| NPI | 1851042295 |
|---|---|
| Former Legal Business Name | FOGODEMISA HOME CARE LLC |
| Entity Type | Organization |
| Authorized Contact | GOLD E OMOGBEHIN Agency Director 910-670-1061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-02-14 |