| NPI | 1710750815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN ELLIOTT Program Administrator 410-466-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |