| NPI | 1679382154 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 172A00000X Driver (Licence: NE H12741346) |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |