NPI | 1316578917 |
---|---|
Entity Type | Organization |
Authorized Contact | LEKEYA HUTTON Owner 443-559-8354 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2020-02-01 |
Last Update Date | 2021-01-12 |