| NPI | 1295362960 |
|---|---|
| Former Name | LACEY RENEE PRILL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 376J00000X Homemaker |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |