| NPI | 1013622273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIERRA BURLEY Credentialing Specialist 410-314-1030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2025-04-16 |