| NPI | 1457134132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA RENEE RICHARDSON Administrative Director 443-401-0787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2023-08-31 |