| NPI | 1063190783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOWANNA MONIQUE MILLER-JOHNSON Owner 443-415-1937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-10-31 |