| NPI | 1124997077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W. SHOENFELT Chief Revenue Officer 410-608-4817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2025-10-30 |