| NPI | 1033640735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC NH053) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: NC NH053) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |