| NPI | 1871194274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251C00000X |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care (Licence: GA 903667039) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2022-10-26 |