| NPI | 1356988745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN HERRON Clinical Director 410-227-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |