| NPI | 1164167334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADINATU DEEN CEO 301-433-1523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-09-06 |