| NPI | 1750839585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHAN GUGSA Program Administrator 410-382-3270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2018-04-02 |