| NPI | 1003528506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY BATES Owner 443-981-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2022-12-16 |