| NPI | 1114277670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 1032300-4-CFC) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN 1032300-4-CFC) |
| 251E00000X Home Health (Licence: MN 1032300-4-CFC) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MN 1032300-4-CFC) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MN 1032300-4-CFC) | |
| 347C00000X Private Vehicle (Licence: MN 1032300-4-CFC) | |
| 385H00000X Respite Care (Licence: MN 1032300-4-CFC) | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: MN 1032300-4-CFC) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: MN 1032300-4-CFC) | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child (Licence: MN 1032300-4-CFC) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |