| NPI | 1245615418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI FIELDS Credentialing/Billing Consultant 443-559-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-12-15 |