| NPI | 1588176697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIA AJAYI Manager 240-374-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |