| NPI | 1285175570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BISHOP Director Of Operations 410-831-3904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 100973) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |