| NPI | 1831803535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISHA SHANE JACKSON CEO And Program Director 443-442-4242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-02-27 |