| NPI | 1356404057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE BRICKHOUSE Controller 410-910-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X Community/Behavioral Health | |
| 251X00000X Supports Brokerage | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 3747P1801X Technician Personal Care Attendant | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |