| NPI | 1679068787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEETA BRANCH COO 443-546-8253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2018-06-30 |
| Last Update Date | 2021-04-14 |