| NPI | 1114751385 |
|---|---|
| Former Legal Business Name | FIRST BASE LLC |
| Entity Type | Organization |
| Authorized Contact | MARQUITA THOMAS CEO 443-683-7696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-09-20 |