| NPI | 1396202511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDELIS SAB CEO 240-350-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-02-24 |
| Last Update Date | 2019-02-24 |