| NPI | 1669930186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AK 101241) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 310400000X Assisted Living Facility | |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-03-04 |