| NPI | 1134774755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEA KEPHART Executive Director 301-573-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2024-01-11 |