NPI | 1619619699 |
---|---|
Entity Type | Organization |
Authorized Contact | JOANNE GRANRUTH Owner 443-463-8035 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2022-04-11 |
Last Update Date | 2022-04-11 |