| NPI | 1235726191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care (Licence: OH 2573301) |
| Additional Taxonomies | 172A00000X Driver (Licence: OH 2573301) |
| 251X00000X Supports Brokerage (Licence: OH 2573301) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OH 2573301) | |
| 347C00000X Private Vehicle (Licence: OH 2573301) | |
| 372600000X Adult Companion (Licence: OH 2573301) | |
| 3747P1801X Technician, Personal Care Attendant (Licence: OH 2573301) | |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-28 |