| NPI | 1275843823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 11942515) |
| 347E00000X Transportation Broker (Licence: TX 11942515) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |