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 |