| NPI | 1841903812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAPHAEL FOMBA Administrator 202-830-4682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2023-01-04 |
| Last Update Date | 2023-01-04 |