| NPI | 1851907141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN HERRON Vice President 410-227-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 251S00000X |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2023-09-06 |