| NPI | 1942472238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIATU JOBI Director 301-937-0188 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2022-10-05 |