| NPI | 1609622448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 177F00000X Lodging | |
| 183700000X Pharmacy Technician | |
| 374U00000X Home Health Aide | |
| 251E00000X Home Health | |
| 132700000X Dietary Manager | |
| 146D00000X Personal Emergency Response Attendant | |
| 171000000X Military Health Care Provider | |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 172A00000X Driver (Licence: AR 904810414) | |
| 174200000X | |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |