| NPI | 1023952017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174200000X Meals |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X Community/Behavioral Health | |
| 177F00000X Lodging | |
| 251300000X Local Education Agency (LEA) | |
| 251B00000X Case Management | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2026-04-18 |
| Last Update Date | 2026-04-21 |