| NPI | 1043989031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH LEWIS Owner 443-869-3659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |