| NPI | 1326612128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUTRESA LANKFORD-PURNELL Clinical Coordinator 410-202-6716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2023-05-25 |