| NPI | 1356942361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL COOPER CFO 410-810-2468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-09 |