| NPI | 1336973452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: CO 7248255179) |
| 172A00000X Driver (Licence: OH RU837343) | |
| 251X00000X Supports Brokerage | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: OH RU837343) | |
| 347C00000X Private Vehicle (Licence: OH RU837343) | |
| 3747P1801X Technician Personal Care Attendant | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2024-08-30 |