| NPI | 1700181880 |
|---|---|
| Former Name | NDIDI UKA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 60123) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 79601) |
| 172V00000X Community Health Worker | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 385H00000X Respite Care | |
| 385HR2050X Respite Care, Respite Care Camp | |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2024-12-01 |