| NPI | 1659890499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 172A00000X Driver | |
| 174200000X Meals | |
| 251E00000X Home Health | |
| 251X00000X | |
| 347C00000X Private Vehicle | |
| 372500000X Chore Provider | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |