| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 311Z00000X Custodial Care Facility |
| 311ZA0620X Custodial Care Facility, Adult Care Home |
| 315D00000X Hospice, Inpatient |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-06-28 |
| Last Update Date | 2025-06-28 |