| NPI | 1053925313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 385H00000X Respite Care |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| 103K00000X Behavior Analyst | |
| 374U00000X Home Health Aide | |
| 1041S0200X Social Worker, School | |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 372600000X Adult Companion | |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-05-28 |