NPI | 1063632602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 305S00000X Point of Service (Licence: KS 17-00935) |
Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KS 17-00935) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2007-07-08 |