| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 372500000X Chore Provider |
| 372600000X Adult Companion |
| 3747A0650X Technician Attendant Care Provider |
| 3747P1801X Technician Personal Care Attendant |
| 385H00000X Respite Care |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities |
| 385HR2065X Respite Care Respite Care, Physical Disabilities, Child |
| 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician |
| 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-01-16 |