| NPI | 1275019580 |
|---|---|
| Doing Business As | ISSAIAH HOUSE 1 |
| Entity Type | Organization |
| Authorized Contact | DARRYL EDWARD BRAXTON Director 443-882-1943 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD BH000372) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2019-06-14 |