| NPI | 1972928554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 000858400) |
| Additional Taxonomies | 251E00000X Home Health (Licence: FL 000858400) |
| 253Z00000X In Home Supportive Care (Licence: FL 000858400) | |
| 310400000X Assisted Living Facility (Licence: FL 000858400) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: FL 000858400) | |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2014-02-19 |