| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Additional Taxonomies | 251B00000X Case Management |
| 253Z00000X In Home Supportive Care |
| 261QD1600X Clinic/Center, Developmental Disabilities |
| 261QM0850X Clinic/Center, Adult Mental Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2025-10-20 |
| Last Update Date | 2025-10-20 |