| NPI | 1518626704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN AMOYAL CEO 410-818-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2024-07-12 |