| NPI | 1447682646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENE LAKE Executive Director 410-974-6829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD lc0225) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2013-07-30 |