| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 385H00000X Respite Care |
| 385HR2050X Respite Care, Respite Care Camp |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| 372500000X Chore Provider |
| 261QD1600X Clinic/Center, Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 343900000X Non-emergency Medical Transport (VAN) |
| 372600000X Adult Companion |
| 373H00000X Day Training/Habilitation Specialist |
| 261QA0600X Clinic/Center, Adult Day Care |
| 225800000X Recreation Therapist |
| 251C00000X Day Training, Developmentally Disabled Services |
| 253Z00000X In Home Supportive Care |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2020-08-31 |