| NPI | 1972900256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CO 1094-21) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: CO 1488-01) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |