| NPI | 1457880858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP1600X Counselor, Pastoral | |
| 171W00000X Contractor | |
| 171WH0202X Contractor, Home Modifications | |
| 253Z00000X In Home Supportive Care | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |