| NPI | 1073766234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MO 2005009896) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MO 2005009896) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2009-11-11 |