| NPI | 1639421894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 320600000X) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2012-10-11 |