| NPI | 1891238564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA L NELSON President 678-308-4082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: GA 055130440) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: GA 055130440) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |