| NPI | 1518461599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONJA DESHAWN CARRERA Director 301-806-4791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |