| NPI | 1003439431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LAMB Director Of Administration 410-975-0067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2024-12-23 |