| NPI | 1932574670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WI 0014242) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WI 0013030) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WI 0015707) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: WI 0014938) | |
| 320700000X Residential Treatment Facility, Physical Disabilities (Licence: WI 0013357) | |
| 320700000X Residential Treatment Facility, Physical Disabilities (Licence: WI 0015444) | |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |