| NPI | 1669136933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA NICHOLE MILBOURNE Owner 410-831-1577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-10-23 |
| Last Update Date | 2023-12-27 |