| NPI | 1952764102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: AZ AL9899H) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: AZ AL10146H) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2023-04-19 |