| NPI | 1477116457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 2082444dca) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NY 2082444) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2023-12-12 |