| NPI | 1750958153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: LA 138729) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: LA 138729) |
| Enumeration Date | 2021-06-06 |
| Last Update Date | 2021-06-06 |