| NPI | 1326596651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE WEST WATSON Program Manager 410-467-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |