| NPI | 1790494136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2022-11-17 |