| NPI | 1679210967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VENNIETH MCCORMICK Executive Director 240-253-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-10-11 |