| NPI | 1407386428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYTHE MOYER Billing Director 443-974-3027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD 904345) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-07-21 |