| NPI | 1700554276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 172A00000X Driver |
| 347C00000X Private Vehicle | |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2021-08-31 |