| NPI | 1518640291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINA KHAN CEO 571-442-4053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-08-09 |