Organization
11714 TUSCANY DRIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGOZI MARYANN OKUDOH (ADMINISTRATOR)
(301) 332-7222
Entity
Organization
Contact information
Practice address
11714 TUSCANY DR, LAUREL, MD 20708-2841
(301) 332-7222
Mailing address
11714 TUSCANY DR, LAUREL, MD 20708-2841
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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