| NPI | 1932970498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORIAH MCNACK Co Partner 469-515-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251E00000X Home Health |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| 332BD1200X Durable Medical Equipment & Medical Supplies Dialysis Equipment & Supplies | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-01-26 |