| NPI | 1295724656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. CHARLES SMITH C.E.O., Sponsor 410-322-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: MD 12234) |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone (Licence: MD 101202) |
| 174400000X Specialist (Licence: MD 101202) | |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2010-12-01 |