| NPI | 1558997296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH COLLINS Managing Partner 410-982-6355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2020-04-20 |