| NPI | 1366137929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE MOUNTAIN Compliance 443-204-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |