| NPI | 1205587359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENNIETH MCCORMICK Director 240-253-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2024-08-14 |