| NPI | 1366095887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELORES KING Executive Director 443-473-6804 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |