| NPI | 1780370825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 347C00000X Private Vehicle (Licence: OH Rp085271) |
| Additional Taxonomies | 332U00000X Home Delivered Meals (Licence: OH Rp085271) |
| 376J00000X Homemaker (Licence: OH Rp085271) | |
| 385H00000X Respite Care (Licence: OH Rp085271) | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child (Licence: OH Rp085271) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: OH Rp085271) | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-09-15 |