| NPI | 1144015041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE MOUNTAIN Compliance 443-289-8606 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-04-11 |
| Last Update Date | 2025-04-11 |