| NPI | 1487227989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 251G00000X Hospice Care, Community Based | |
| 310400000X Assisted Living Facility | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2023-09-29 |