| NPI | 1114250503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK JOSEPH HUDAK Director/Owner 410-576-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MD 903571) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2009-09-16 |