| NPI | 1881152460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONDRAL JACKSON Owner 989-395-4874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 251J00000X Nursing Care | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |