| NPI | 1114682093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSE OKOJIE Owner 443-629-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2022-10-14 |