| NPI | 1376382515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX MATTHEW Administrator 202-725-1570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |