| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 101Y00000X Counselor |
| 171W00000X Contractor |
| 172A00000X Driver |
| 251C00000X |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle |
| 3747P1801X Technician, Personal Care Attendant |
| 374U00000X Home Health Aide |
| 376J00000X Homemaker |
| 385HR2050X Respite Care, Respite Care Camp |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-03-11 |