| NPI | 1073226437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253J00000X Foster Care Agency (Licence: ID chf-2918) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 310400000X Assisted Living Facility (Licence: ID chf-2918) | |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2023-02-16 |