NPI | 1407158884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 310400000X Assisted Living Facility (Licence: NC 017059) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 381) |
3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: NC 017059) | |
3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: NC 017059) | |
310500000X Intermediate Care Facility, Mental Illness (Licence: NC 017059) | |
Enumeration Date | 2010-11-17 |
Last Update Date | 2022-02-08 |