| NPI | 1639096613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2026-07-01 |
| Last Update Date | 2026-07-01 |