| NPI | 1043084718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-12-31 |