| NPI | 1962191544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LAKE Owner 662-571-2025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |