| NPI | 1629958616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385HR2050X Respite Care, Respite Care Camp |
| Additional Taxonomies | 172A00000X Driver |
| 106S00000X Behavior Technician (Licence: NC RBT-24-392496) | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385H00000X Respite Care | |
| 3747P1801X Technician, Personal Care Attendant | |
| 372600000X Adult Companion | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-10-04 |