| NPI | 1972960417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE ANN NICHOLS CEO 410-530-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: VA 2016-263838-R) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |