| NPI | 1922275932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KOWALCZYK Controller 410-910-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2023-05-11 |