| NPI | 1902402795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH 274348) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH 274348) |
| 261QA0600X Clinic/Center, Adult Day Care (Licence: OH 274348) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OH 274348) | |
| 347C00000X Private Vehicle (Licence: OH 274348) | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |