| NPI | 1275115495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON HEABERLIN Credentialing Specialist 410-415-3385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2024-01-12 |