| NPI | 1780577973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 372600000X Adult Companion | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-05-29 |