| NPI | 1346776580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LYLE Billing Specialist 410-233-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-11 |