| NPI | 1780317834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMI WELLS Owner 443-960-1497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2024-01-02 |