| NPI | 1164296646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FOLEFAC FOFUELAKA Owner/Manager 240-701-6013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |