| NPI | 1609632462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Additional Taxonomies | 172A00000X Driver |
| 251X00000X | |
| 332U00000X Home Delivered Meals | |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-02-27 |
| Last Update Date | 2024-02-27 |