| 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 |