| NPI | 1326637232 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6907046) |
| Additional Taxonomies | 372500000X Chore Provider (Licence: FL 6907046) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2022-04-01 |