| NPI | 1376040741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AL11336) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL Al12522) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |