Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
|
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 171M00000X Case Manager/Care Coordinator |
| 171W00000X Contractor |
| 175T00000X Peer Specialist |
| 225C00000X Rehabilitation Counselor |
| 251B00000X Case Management |
| 251X00000X Supports Brokerage |
| 261QA0600X Clinic/Center, Adult Day Care |
| 261QM1300X Clinic/Center, Multi-Specialty |
| 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2018-12-07 |
Last Update Date | 2018-12-07 |