| NPI | 1083068563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GERARD LUECKING Business Manager 301-696-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 06287) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2022-11-07 |