| NPI | 1720149982 |
|---|---|
| Other Name | LUCKY ENTERPRISE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 251B00000X Case Management |
| 251X00000X Supports Brokerage | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2022-03-29 |