| NPI | 1003408329 |
|---|---|
| Other Name | BAYONNE AVENUE |
| Entity Type | Organization |
| Authorized Contact | PIETRO SORRENTINO CEO 410-591-3565 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2022-02-10 |