| NPI | 1912699406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAIRA RAY CEO 443-800-6213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2023-09-27 |