| NPI | 1265416994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE COSTLEY Credentialing Specialist 443-839-6928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD 8314) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2024-07-25 |