| NPI | 1295422855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENGNI DJIOGO Program Director 443-720-9482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |