NPI | 1528790821 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXANDER BLACK Owner 410-260-9338 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 251S00000X |
261QM0850X Clinic/Center, Adult Mental Health | |
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
323P00000X Psychiatric Residential Treatment Facility | |
Enumeration Date | 2022-06-27 |
Last Update Date | 2024-04-05 |