| NPI | 1083390744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SULE ISHOLA SALAKO Administrator 443-804-7652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |