| NPI | 1558192252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: TX 001035425) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 251G00000X Hospice Care, Community Based | |
| 372600000X Adult Companion | |
| 374U00000X Home Health Aide | |
| 376J00000X Homemaker | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2026-07-24 |