| NPI | 1437822665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY L GORDON Owner 443-949-9545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 251S00000X | |
| Enumeration Date | 2021-07-25 |
| Last Update Date | 2021-10-05 |