| NPI | 1184152571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYTHE MOYER Billing Director 443-974-3027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD 906064) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2017-05-30 |