| NPI | 1285498501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEVON ANDRE PATRICK Owner/CEO 410-501-9796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |