| NPI | 1194431445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG HOWARD LIPPENS Program Administrator 410-382-0528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-30 |