| NPI | 1043409584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE BRICKHOUSE Controller 410-910-1489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: NC 064-079) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2007-10-22 |