| NPI | 1578219721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETTY M NGONA CEO 443-465-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-02-25 |