| NPI | 1336747518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: WI 0017514) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: WI 0017514) |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2020-10-12 |