| NPI | 1225887557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKWA GREMBOWSKI Owner 443-506-7562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 276400000X Rehabilitation, Substance Use Disorder Unit |
| 251E00000X Home Health | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2025-10-07 |