| NPI | 1649851825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: CA 300659BP) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2021-04-19 |