| NPI | 1508547431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHLYN CLARKE CEO 443-929-1928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2024-04-09 |