| NPI | 1316517485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN RECK Manager 410-220-0720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2025-12-10 |