| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 174200000X Meals |
| 251300000X Local Education Agency (LEA) |
| 251B00000X Case Management |
| 251T00000X PACE Provider Organization |
| 251E00000X Home Health |
| 251S00000X Community/Behavioral Health |
| 252Y00000X Early Intervention Provider Agency |
| 253Z00000X In Home Supportive Care |
| 261QA0600X Clinic/Center, Adult Day Care |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-09 |