| NPI | 1497730204 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | JOHN E HICKEY Executive Director 410-233-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD 10415) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |