| NPI | 1316865744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 342000000X Transportation Network Company | |
| 3747P1801X Technician, Personal Care Attendant | |
| 385H00000X Respite Care | |
| Enumeration Date | 2026-07-06 |
| Last Update Date | 2026-07-06 |