| NPI | 1659987998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 310400000X Assisted Living Facility | |
| 347C00000X Private Vehicle | |
| 376J00000X Homemaker | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |