| NPI | 1952936841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 311Z00000X Custodial Care Facility | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 347C00000X Private Vehicle | |
| 372500000X Chore Provider | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |