| NPI | 1063692655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KIRK DOUGLAS Director 410-233-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 903365) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD 903365) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2023-05-10 |