| NPI | 1447704648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASITY L STACY Program Manager 443-531-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |