| NPI | 1962211060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN GARDNER Owner 301-928-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2025-05-23 |