| NPI | 1992513485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: VA 0735001139) |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |