| NPI | 1376419580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN JOHNSON Owner 443-944-1835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-10-14 |