| NPI | 1235701046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN BRIDGERS CEO 410-419-4975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-08-18 |