| NPI | 1043998321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUHEAD BURKE Owner 443-570-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-07-07 |
| Last Update Date | 2023-07-07 |