| NPI | 1891538690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: KY B10-059-414) |
| Additional Taxonomies | 251E00000X Home Health (Licence: KY B10-059-414) |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |