| NPI | 1033953591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLOMON TABE Administrator 301-693-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2024-06-20 |