| NPI | 1104069384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ME ALLS 2805) |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |