| NPI | 1710581285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2020-11-25 |