| NPI | 1609467836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: FL 5582-6-GA) |
| Enumeration Date | 2021-01-30 |
| Last Update Date | 2021-01-30 |