| NPI | 1679900641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS AMIBANG TANUE Administrator 301-257-3504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |