| NPI | 1588448534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 104100000X Social Worker |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-08-22 |
| Last Update Date | 2023-08-22 |