| NPI | 1942088927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAREBA KERRIEM Owner 443-857-5230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2025-01-28 |