| NPI | 1427352681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SEGAL Director Of Clinical Operations 301-563-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MD 1053589242) |
| Additional Taxonomies | 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: MD 904039) |
| 261Q00000X Clinic/Center (Licence: MD 904039) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MD 904039) | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |