NPI | 1871207985 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 11482803) |
Enumeration Date | 2023-01-12 |
Last Update Date | 2023-01-12 |