| NPI | 1326612128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KUTRESA LANKFORD-PURNELL Clinical Coordinator 410-202-6716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2025-06-11 |