| NPI | 1205285202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX GREEN CEO 410-808-2786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC2308) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC2308) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |