| NPI | 1912030107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHATAUNDRIA COTTON Owner 708-548-8474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251E00000X Home Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-11-18 |