| NPI | 1265887434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL EDWARD BRAXTON Licence Professional Counselor 443-882-1943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD LC7034) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MD LC7034) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |