| NPI | 1154310225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY SCHULDEN Executive Director 410-752-5525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2011-10-28 |