| NPI | 1922501766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MO WL-1004-INIT) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |