| NPI | 1487520417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASAMNEW GEBREMARIAM Owner 571-276-7508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2025-10-16 |
| Last Update Date | 2025-10-16 |