NPI | 1518625896 |
---|---|
Entity Type | Organization |
Authorized Contact | MAKEDA ESSIM Program Director 571-351-3476 |
Organization Subpart ? | No |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2021-12-03 |
Last Update Date | 2021-12-03 |