| NPI | 1831755958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBENEZER BANAHENE President 703-926-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |