| NPI | 1972181600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SMITH Program Director 410-304-6670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2021-04-01 |