| NPI | 1619375235 |
|---|---|
| Former Name | LINDA MAXINE RICKETTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: MN R 1080210) |
| Enumeration Date | 2014-12-13 |
| Last Update Date | 2014-12-13 |