| NPI | 1609100833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2013-04-04 |