| NPI | 1992472120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIKATA KHYNE-SAM Director 703-401-4133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-08-25 |