| NPI | 1114484714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MT 31530) |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2026-04-24 |