| NPI | 1003452749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 385H00000X Respite Care (Licence: AZ 13650767) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AZ 13650767) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2026-08-12 |