| NPI | 1710448287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 311500000X Alzheimer Center (Dementia Center) | |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |