A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Home Health | 251E00000X |
| Meals | 174200000X | |
| Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | 251T00000X | |
| Voluntary or Charitable | 251V00000X |
* Indicates primary specialty
| NPI Number | 1649077025 |
| Credentials | |
| Entity | Individual |
| Enumeration date | 02/25/2025 |
| Last updated | 12/02/2025 - About 6 months ago |
| Sole proprietor1 | Yes |
| Identifiers | n/a |
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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