| NPI | 1821205246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OR 3245S0500x) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |