| NPI | 1811433329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2022-03-30 |