| NPI | 1982202271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKLIN HEKIMA JACKSON Owner 240-305-2723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-11-13 |