| NPI | 1467147272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 372500000X Chore Provider | |
| Enumeration Date | 2023-04-07 |
| Last Update Date | 2023-04-22 |