| NPI | 1083233886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CA 019201069) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CA 019201069) | |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2021-05-18 |