| NPI | 1922554252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906683) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2019-01-27 |