| NPI | 1184132433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMORUYI EPHRAIM K. OKUNDAYE CEO / Clinical Director 443-682-5807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: MD 17618) |
| Additional Taxonomies | 251B00000X Case Management (Licence: MD 17618) |
| 251S00000X (Licence: MD 17618) | |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-20 |