| NPI | 1811367089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| 172A00000X Driver (Licence: NJ A97615840008602) | |
| 343800000X Secured Medical Transport (VAN) | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 347E00000X Transportation Broker | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2016-05-15 |