| NPI | 1952880015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMARA MONTGOMERY Owner/CEO 301-437-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VA 3032) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |