| NPI | 1205216470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 261QC1500X Clinic/Center, Community Health | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 376G00000X Nursing Home Administrator | |
| 385H00000X Respite Care | |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2024-06-11 |