NPI | 1346952660 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
Enumeration Date | 2022-12-19 |
Last Update Date | 2022-12-19 |