| NPI | 1467325209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CLARKE Executive 443-378-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-09-27 |
| Last Update Date | 2025-09-27 |