| NPI | 1538839725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEION CAISON Owner 443-204-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2022-08-02 |