| NPI | 1790273522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PORSHIA EVERETT Director 301-971-2639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-06-16 |