| NPI | 1023741717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LIVELY Chief Operating Officer 443-878-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2025-01-09 |