| NPI | 1356104327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL HARP-WITHERSPOON Ownerr 410-776-8639 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 261QM2500X Clinic/Center Medical Specialty | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2024-02-02 |
| Last Update Date | 2024-02-20 |