| NPI | 1861273252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINE N BROAD Owner 234-425-8849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251F00000X Home Infusion |
| 251J00000X Nursing Care | |
| 251X00000X Supports Brokerage | |
| 253Z00000X In Home Supportive Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2024-07-10 |