| NPI | 1861077018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANETTA LEGGETT Owner 910-814-1305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| 251E00000X Home Health | |
| 251F00000X Home Infusion | |
| 251J00000X Nursing Care | |
| 253Z00000X In Home Supportive Care | |
| 291900000X Military Clinical Medical Laboratory | |
| 291U00000X Clinical Medical Laboratory | |
| 293D00000X Physiological Laboratory | |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-07-15 |