| NPI | 1619657194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA MCCASKILL CEO 443-910-5835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center, Recovery Care | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2024-01-09 |