| NPI | 1699647933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYANTUS TOLLOSA Owner 240-470-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-18 |
| Last Update Date | 2025-09-23 |