| NPI | 1669726162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASSANA JONES Administrator 202-805-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: TX 783687) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |