| NPI | 1861283517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY IMMI K Administrator 240-584-8869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 310400000X Assisted Living Facility | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |