| NPI | 1336919737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVEN DICKENS CEO 410-527-1972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X Community/Behavioral Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-01-05 |