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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
163WG0000X |
| NPI # | 1013530443 |
| LBN Legal business name | DISTINCTIVE HOMECARE LLC |
| Authorized official | BENJAMIN DEGRAFT KOOMSON - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 05/20/2020 |
| Last updated | 05/20/2020 - About 6 years ago |
| Identifiers | n/a |
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DISTINCTIVE HOMECARE LLC
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DISTINCTIVE HOMECARE LLC