| NPI | 1710825120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| Enumeration Date | 2026-03-24 |
| Last Update Date | 2026-04-13 |