NPI | 1013695113 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRI FIELDS Credentialing Consultant 443-567-6120 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QR0800X Clinic/Center Recovery Care | |
Enumeration Date | 2023-07-07 |
Last Update Date | 2023-08-01 |