| NPI | 1578884714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE MARIAN CROCKETT Owner/Manager 301-393-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MD 21ALOO95-A) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |