| NPI | 1538657630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LEA BARKDOLL Cred Coordinator 301-733-0331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: MD BH000027) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-10-01 |