| NPI | 1982807616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 310400000X Assisted Living Facility | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2025-09-11 |