| NPI | 1144182098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2025-12-01 |
| Last Update Date | 2025-12-01 |