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 |