| NPI | 1780846451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MO 2008014718) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: IL 178.005558) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2008-06-25 |