| NPI | 1568076719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIBLETS GHEBRE Program Director 703-317-7458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |