| NPI | 1194236315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2017-10-15 |
| Last Update Date | 2017-10-15 |