| NPI | 1811636616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 376J00000X Homemaker |
| 385H00000X Respite Care | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-05-31 |