Organization
LIVING GOOD CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILASTEEN MIDDLETON PH.D (OWNER)
(301) 705-5498
Entity
Organization
Contact information
Practice address
3133 EUTAW FOREST DR, WALDORF, MD 20603-4070
(301) 705-5498
(301) 705-5498
Mailing address
3133 EUTAW FOREST DR, WALDORF, MD 20603
(301) 705-5498
(301) 705-5498
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MD
Other
Enumeration date
03/07/2009
Last updated
03/07/2009
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