| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| 310400000X Assisted Living Facility |
| 251C00000X Day Training, Developmentally Disabled Services |
| 251E00000X Home Health |
| 253J00000X Foster Care Agency |
| 261QD1600X Clinic/Center, Developmental Disabilities |
| 251G00000X Hospice Care, Community Based |
| 251S00000X |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2022-09-25 |