| NPI | 1346566783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 251G00000X Hospice Care, Community Based | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2019-06-04 |