| NPI | 1063241206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAM NABIRYE Administrator 571-282-8441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2024-07-27 |