NPI | 1255214177 |
---|---|
Entity Type | Organization |
Authorized Contact | SIARA BAZEMORE Owner 410-816-4401 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
Enumeration Date | 2025-07-29 |
Last Update Date | 2025-07-29 |