| NPI | 1104984806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA RADER Administrator 202-730-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MD D21642) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |