| NPI | 1164219333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider |
| 374T00000X Religious Nonmedical Nursing Personnel | |
| 374U00000X Home Health Aide (Licence: FL CNA372924) | |
| 376G00000X Nursing Home Administrator (Licence: FL 171245510) | |
| 376G00000X Nursing Home Administrator | |
| 376K00000X Nurse's Aide (Licence: FL CNA372924) | |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-04-22 |