| NPI | 1144101668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERNIBA GHONEIM CEO 301-569-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |