| NPI | 1578331963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEMOLA STEPHEN AKINROGBE Administrator 410-525-5285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2024-03-15 |