| NPI | 1528473006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2025-01-23 |