| NPI | 1619650116 |
|---|---|
| Doing Business As | DBA SUD RES AT 1116 E 20TH STREET |
| Entity Type | Organization |
| Authorized Contact | VERNON HOLMES CEO 443-478-0384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-10 |