| NPI | 1962148908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA FAYE COMMODORE Owner 769-204-3699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251E00000X Home Health |
| 385H00000X Respite Care | |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |