| NPI | 1407187420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALEX GREEN CEO 410-808-2786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC2308) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC2308) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA 196) | |
| 101YM0800X Counselor, Mental Health (Licence: MD LC 2343) | |
| 101YP2500X Counselor, Professional (Licence: MD LC2308) | |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |