| NPI | 1770397994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 372600000X Adult Companion |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-02-06 |
| Last Update Date | 2025-02-06 |