| NPI | 1275388043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLA JACKSON CEO 443-388-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2024-04-23 |
| Last Update Date | 2024-04-23 |