| NPI | 1659261378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERTA BANYONG Owner 240-643-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-04 |
| Last Update Date | 2025-07-04 |