| NPI | 1083303945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ D09521021) |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2025-12-03 |