| NPI | 1306016787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NY 069789) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |