| NPI | 1487335493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA S LOGAN Owner 443-416-5667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |