| NPI | 1447997465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOMOH SONGA Administrator 571-484-8057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-06-06 |