| NPI | 1730663139 |
|---|---|
| Former Name | PAMELA SUE WARREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: OH PN087638) |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2018-09-20 |