NPI | 1972934685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC MHL001233) |
Enumeration Date | 2013-12-05 |
Last Update Date | 2014-01-07 |