| NPI | 1063296408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDONIE BONGAM Director 301-537-8248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-08-24 |
| Last Update Date | 2024-04-19 |