| NPI | 1083339782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENNEITH MCCORMICK Director 240-253-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2024-08-19 |