| NPI | 1083045306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: NC MHL-047-152) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: SC 27-0962043) |
| 347C00000X Private Vehicle (Licence: SC 27-0962043) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2015-01-09 |