Provider First Line Business Practice Location Address: 
RECOVERY CENTERS OF AMERICA AT BRACEBRIDGE HALL
    Provider Second Line Business Practice Location Address: 
314 GROVE NECK RD
    Provider Business Practice Location Address City Name: 
EARLEVILLE
    Provider Business Practice Location Address State Name: 
MD
    Provider Business Practice Location Address Postal Code: 
21919-3008
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
410-275-6200
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
12/04/2015