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 |