| NPI | 1083196836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: GA PCH007436) |
| Additional Taxonomies | 163WC1500X Registered Nurse Community Health (Licence: GA RN249535) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |