| NPI | 1760963482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |