| NPI | 1134640998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: OK NH6609) |
| 311Z00000X Custodial Care Facility (Licence: OK NH6603-6603) | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2018-03-17 |