| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TA0700X Psychologist Adult Development & Aging |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| 104100000X Social Worker |
| 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health |
| 251S00000X Community/Behavioral Health |
| 261QA0600X Clinic/Center Adult Day Care |
| 261QD1600X Clinic/Center Developmental Disabilities |
| 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |