Organization
BAYOU ESTATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INEISHA JOHNSON BADAROU (OWNER)
(301) 503-6723
Entity
Organization
Contact information
Practice address
12203 HOLM OAK DR, WALDORF, MD 20601-4524
(301) 374-8932
Mailing address
12203 HOLM OAK DR, WALDORF, MD 20601-4524
(301) 374-8932
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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