| NPI | 1073237350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-09-29 |