| NPI | 1700322138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AZ AL10178H) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: AZ AL10178H) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |