| NPI | 1356796668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAIAH A TEASLEY CEO 240-750-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 08041139) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |