| NPI | 1366896482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906761) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: FL 6906761) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2017-05-17 |