| NPI | 1124448360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: NE 992) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NE 992) |
| 311500000X Alzheimer Center (Dementia Center) (Licence: NE 992) | |
| 314000000X Skilled Nursing Facility (Licence: NE 992) | |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2014-04-25 |