| NPI | 1083312458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONKE FUNKE IZIOGO CEO 443-536-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2023-02-15 |