| NPI | 1467167981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FON EMBOLA Owner 240-481-2808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-01-19 |