| NPI | 1497533525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN NDOMBI TANTOH Director 443-466-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-28 |