| NPI | 1154076784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SIMON Owner 443-822-3459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |