| NPI | 1366042590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE LIVERPOOL Owner 443-710-3061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2026-02-12 |