| NPI | 1114705332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TITILAYO LATEEF Managing Owner 443-554-6382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 273Y00000X Rehabilitation Unit | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |