| NPI | 1407335474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKISHA N KING Executive Director 571-348-2356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 253Z00000X In Home Supportive Care | |
| 251E00000X Home Health | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2018-08-10 |
| Last Update Date | 2026-06-21 |