| NPI | 1124980388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 5448-01-001) |
| Enumeration Date | 2025-11-25 |
| Last Update Date | 2025-11-25 |