| NPI | 1487358420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEMETTE BASS CFO 443-762-2603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2024-06-05 |