| NPI | 1023686284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOVID LAX Chief Executive Officer 410-409-3662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| 207Q00000X Family Medicine | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2025-07-25 |