| NPI | 1497316715 |
|---|---|
| Doing Business As | PROVIDENCE INTEGRATED HEALTHCARE |
| Entity Type | Organization |
| Authorized Contact | KAY ATOLOYE Program Director / CEO 443-929-8315 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2022-06-09 |