| NPI | 1083164339 |
|---|---|
| Doing Business As | ADULT AND COMMUNITY CBHOT |
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN CLENDANIEL Billing Manager 410-810-2465 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-05-02 |