| NPI | 1154626752 |
|---|---|
| Doing Business As | MOUNTAIN MANOR ADULT OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | WILLIAM J ROBY Executive Vice President 301-447-2361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 903870) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2022-09-07 |