| NPI | 1053456715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 171W00000X Contractor (Licence: TX 117902) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2019-03-27 |