| NPI | 1225583123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EHSAN ABDESHAHIAN Medical Director 410-800-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-08-20 |