| NPI | 1114397676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD RIAZ AHMAD Administrator 410-788-6407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD CAC-AD, AC 0313) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD CAC-AD, AC0313) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD CAC-AD, AC0313) | |
| 101YM0800X Counselor, Mental Health (Licence: MD CAC-AD, AC0313) | |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-28 |