| NPI | 1124891759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHINELLE OGLESBY CEO 410-844-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |