| NPI | 1063875003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: FL 140728759) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL 140728759) |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: FL 140728759) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-04-14 |