| NPI | 1225411531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB MAMMEN Administrator 301-871-2749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MD 15AL 0504-A) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |