| NPI | 1922711407 |
|---|---|
| Former Legal Business Name | OWNER |
| Entity Type | Organization |
| Authorized Contact | TATYANA ITKINA Manager Administrator 267-699-8643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |