| NPI | 1487293007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH DIBONGE Administrator 240-506-1728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2022-06-28 |