| NPI | 1154000602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRA V MITCHELL CEO/Owner 443-908-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-07-12 |
| Last Update Date | 2023-07-12 |