| NPI | 1104366640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEAH CROSBY CEO 410-831-2138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: MD 4221133) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) (Licence: MD 16681) |
| 251S00000X Community/Behavioral Health (Licence: MD 16681) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-03-02 |