| NPI | 1275578502 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHARON BROY Clinical Director 410-466-1345  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 04058)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA043)  | 
| 101YP2500X Counselor, Professional (Licence: MD LCO380)  | |
| 1041C0700X Social Worker, Clinical (Licence: MD 09114)  | |
| Enumeration Date | 2006-06-19 | 
| Last Update Date | 2025-09-11 |