| NPI | 1477054906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY BUTLER Licensing And Credentialing 410-807-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2022-12-05 |