| NPI | 1336177427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE C PRICE Director Operations 301-389-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: VA 4947941) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: 175-01-001) | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: 175-01-001) | |
| 315P00000X Intermediate Care Facility, Mentally Retarded | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2013-01-03 |