| NPI | 1689838633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE JOLIE CARTER Director Of Services 240-417-9810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: IL 146009176) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |