| NPI | 1669204673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUMPEI TRIOE POLLARD-JACKSON Owner 443-254-1884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |