| NPI | 1265016711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DR LISA WILSON Executive Director 443-779-9901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-07-09 |