| NPI | 1144069089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: 1144069089) |
| 376J00000X Homemaker (Licence: 1144069089) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 253Z00000X In Home Supportive Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2024-09-13 |