| NPI | 1477627495 |
|---|---|
| Other Name | VICKIE GONZALES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: AZ 8896) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |