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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHINASA NWAUKWA (CEO)
(443) 858-7689
Entity
Organization

Contact information

Practice address
1332 LONDONTOWN BLVD STE 15F, ELDERSBURG, MD 21784-6587
(443) 858-7689
(410) 580-1575
Mailing address
1332 LONDONTOWN BLVD STE 15F, ELDERSBURG, MD 21784-6587
(443) 858-7689
(410) 580-1575

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
04/02/2024
Last updated
04/02/2024
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