| NPI | 1306597810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUMOKE FADEKE OMISORE Medical Director 410-903-9206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-01-17 |