| NPI | 1871163154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUEENELLA WISNER Co Owner 267-401-7675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251G00000X Hospice Care, Community Based | |
| 251B00000X Case Management | |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 347E00000X Transportation Broker | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2023-01-24 |