| NPI | 1255009429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MCCALL Program Director 443-463-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-06-03 |