| NPI | 1376317792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RYAN SHRANK Owner 240-565-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |