| NPI | 1053911925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLADALE O AIYEGBUSI Administrator 301-213-9207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |