| NPI | 1508307265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 253J00000X Foster Care Agency |
| 311Z00000X Custodial Care Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2018-08-24 |