| NPI | 1881414621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INYANG EDOHO Owner 240-920-9103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |