| NPI | 1548903552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUISA NASH Owner 443-722-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2025-07-22 |