| NPI | 1790564805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-09-27 |