| NPI | 1457647521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN CLENDANIEL Billing Manager 410-810-2465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2016-10-18 |