| NPI | 1861976003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MOSLEY Owner/Administrator 904-472-5355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2019-10-16 |