NPI | 1447665641 |
---|---|
Entity Type | Organization |
Authorized Contact | BABAK IMANOEL Medical Director 443-475-0737 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MD 905154) |
Enumeration Date | 2014-06-25 |
Last Update Date | 2019-11-24 |