| NPI | 1548789985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA PETERSON Billing Manager 443-440-5782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 17401) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2023-05-10 |