| NPI | 1669648390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLISS JOHNSON Director Of Operations 1800-344-6423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MD 15773) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |