| NPI | 1073941993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness (Licence: TN 1000000013286) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: TN 1000000013286) |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances (Licence: TN 1000000013286) | |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2013-10-31 |