| NPI | 1902566722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 372600000X Adult Companion |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| 253Z00000X In Home Supportive Care | |
| 101YM0800X Counselor, Mental Health | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2021-12-20 |
| Last Update Date | 2024-09-24 |