| NPI | 1063067049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN GAINERS CEO/Director 410-605-0492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |