| NPI | 1154037406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE OTTEY Executive Director 443-523-4459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-07-19 |