| NPI | 1912406208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASHONNA FORNEY Owner 980-273-0425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3747P1801X Technician, Personal Care Attendant |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-02-02 |