| NPI | 1124693148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WILSON Executive Director 443-885-9406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |