| NPI | 1013502384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISSATOU BAH Director 571-235-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2024-08-19 |