| NPI | 1255146239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 385H00000X Respite Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 373H00000X Day Training/Habilitation Specialist | |
| 251S00000X Community/Behavioral Health | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2025-02-08 |
| Last Update Date | 2025-10-10 |