| NPI | 1609507763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUEEN I AUDIFFEREN CEO 443-985-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2024-05-28 |