| NPI | 1659994630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOMODOU SOWE Manager 202-507-9826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2020-05-25 |