| NPI | 1053208751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYNISHA KADIRI CEO/Executive Director 443-466-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2400X Clinic/Center, Prison Health | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QV0200X Clinic/Center, VA | |
| 291U00000X Clinical Medical Laboratory | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-06-23 |