| NPI | 1790542595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN SHEM ANYONA Owner 443-985-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-12-05 |