| NPI | 1538817986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA PETERSON Billing Manager 443-440-5782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2023-10-13 |