| NPI | 1578796371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CT 001883) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: MA 8902) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2009-08-26 |