| NPI | 1649966102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 251E00000X Home Health |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2025-03-18 |