| NPI | 1558355206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRUCE ANZALONE Director 410-951-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MD 03-034) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2020-08-22 |