| NPI | 1336700061 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | FAYTHE JOHNSON VP Tx Coordination & Billing 410-276-1773  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility | 
| Enumeration Date | 2019-06-24 | 
| Last Update Date | 2019-06-24 |