| NPI | 1104635804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH MCALLISTER Owner 443-983-0898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |