| NPI | 1447858618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 172A00000X Driver |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251X00000X | |
| 253Z00000X In Home Supportive Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| Enumeration Date | 2020-10-11 |
| Last Update Date | 2020-10-11 |