| NPI | 1952705378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON EHIOGUH Alt Administrator 469-776-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 251F00000X Home Infusion | |
| 163W00000X Registered Nurse | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2025-10-09 |