| NPI | 1790519031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA PENINA JOHNSON CEO 410-484-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |