| NPI | 1639572159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: NM 14-00005321) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2015-01-16 |