| NPI | 1225677883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M WILSON CEO 443-779-9901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2019-12-31 |