| NPI | 1184585176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN FOUNTAIN Director 443-735-1648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2025-11-19 |