| NPI | 1073778163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: MT 0035030-001) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2024-07-09 |