| NPI | 1063053759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL 49-51-2202828) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-11-16 |