| NPI | 1215180823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLETON HENRY Controller 301-565-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2008-10-28 |