| NPI | 1578008546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK J GRAVELINE Deputy Director 301-926-2300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MD 0179) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |