| NPI | 1467934497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFINIE CARROLL Executive Director 410-363-3713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |