| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 385H00000X Respite Care |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child |
| 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| 251S00000X Community/Behavioral Health |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child |
| Enumeration Date | 2026-03-18 |
| Last Update Date | 2026-03-18 |