| NPI | 1831905348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COBLAH Q GREEN Owner 443-908-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251S00000X | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |