| NPI | 1881231223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRESHINE JOHNSON Owner 267-235-6792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| 251T00000X PACE Provider Organization | |
| 251E00000X Home Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 385H00000X Respite Care | |
| 251300000X Local Education Agency (LEA) | |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |