| NPI | 1487318499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LATASHA SHELL Owner 410-800-6186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-10-26 |