| NPI | 1366165789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUSTON LABRANTE FOUNTAIN CEO 443-454-1507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |