| NPI | 1851838643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE COSTLEY Administrator 443-548-3733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2023-03-24 |