| NPI | 1205493566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CA 361880724) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 271315) |
| 385H00000X Respite Care (Licence: CA 361880724) | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2021-06-18 |