| NPI | 1669891784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL AL7472) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: FL 7472) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2020-12-17 |