| NPI | 1275464802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE WHITNEY Manager 443-759-9015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2026-05-25 |
| Last Update Date | 2026-07-20 |