| NPI | 1023562576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA CHRISTINA KAMMER Program Sponsor 410-477-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |