| NPI | 1417006503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KINNEBERG Director 410-671-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD 13137) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-06-10 |