| NPI | 1164200994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: GA PCH009314) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |