| NPI | 1548023104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 251E00000X Home Health |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-06-22 |