| NPI | 1104792183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORPO KOLLIE JOHNSON President 301-814-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-12-08 |