| NPI | 1922882950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALITA SMITH Owner 443-739-2084 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |