| NPI | 1912644469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: TN l000000030002) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-05-20 |