| NPI | 1053801951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIEL CHICHEPORTICHE Director 410-258-8939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2024-12-03 |