| NPI | 1205795556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| Enumeration Date | 2026-01-21 |
| Last Update Date | 2026-01-21 |