| NPI | 1215548573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEE JEREMI SPENCER Owner 443-418-7064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-10-07 |