| NPI | 1396327805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 171W00000X Contractor |
| 171WH0202X Contractor, Home Modifications | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2021-04-23 |