| NPI | 1407537186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA LOCKETT CFO 443-796-5089 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-08-03 |