| NPI | 1962881276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNESSA RICHARDSON Agency 863-398-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 014133000) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |