| NPI | 1215732771 |
|---|---|
| Other Name | N/A |
| Other Name | NONE |
| Entity Type | Organization |
| Authorized Contact | CLIFFORD KIBANG CEO 240-413-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-02-18 |
| Last Update Date | 2025-02-18 |