| NPI | 1033772389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAWANYA TENE JERRY Billing Specialist 443-221-7447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |