| NPI | 1891486114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN TRACIS Executive 712-713-8870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3747P1801X Technician Personal Care Attendant | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-12-31 |