| NPI | 1295986503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253J00000X Foster Care Agency (Licence: MI AS250010894) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS250010894) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |