| NPI | 1538847991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYANNA D WILLIAMS Billing Coordinator 443-392-6934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251S00000X |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2023-07-06 |