| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities |
| 385H00000X Respite Care |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-04 |