| NPI | 1730464611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 00238902) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 00238902) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |