| NPI | 1801297254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 190081GN) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |