| NPI | 1356139174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL KENNEDY Qualified Professional 240-423-5461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-10-14 |