Organization
MAGNOLIA BEHAVIOR HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIA L SHIRIMA NURSE (CEO)
(301) 305-5731
Entity
Organization
Contact information
Practice address
604 SOLAREX CT UNIT 205, FREDERICK, MD 21703-8655
(301) 305-5731
Mailing address
604 SOLAREX CT UNIT 205, FREDERICK, MD 21703-8655
(301) 305-5731
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
08/23/2023
Last updated
10/26/2023
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