| NPI | 1376180398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL MAZWI Executive Director 443-282-8949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2024-12-02 |