| NPI | 1114733466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY KANGARA Facility Manager 202-821-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-10 |