| NPI | 1114339140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMPHREY SOWHO Administrator 240-481-5991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2014-05-26 |