| NPI | 1477247385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE ASIEDUA LETSA CEO 571-484-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |