| NPI | 1235861261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTEL GREENE Owner 443-847-3749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2023-08-25 |