| NPI | 1376367359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE MARIE STEVENSON Owner 410-508-1104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |