| NPI | 1063623783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES D. SPIVACK Director 410-704-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 100828) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |