| NPI | 1922832252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA P JOHNSON CEO 410-484-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |