| NPI | 1902437916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELA CAMPBELL Clinical Supervisor 443-904-8216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2023-06-14 |