| NPI | 1265628085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS N FON Director 240-461-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MD 060909) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: MD 0609009) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MD 060909) | |
| Enumeration Date | 2007-09-16 |
| Last Update Date | 2007-09-16 |