| NPI | 1386207298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2020-11-28 |