| NPI | 1760221741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WURAOLA RUKAYAT POPOOLA Chief Executive Officer 443-248-2808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2024-05-21 |