| NPI | 1568017358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICODEMUS FONTEM Director 301-346-1870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2019-08-07 |