| NPI | 1801073390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA ALISON COPPIN C.E.O 410-323-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MD 0002078684) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |