| NPI | 1568054476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEARA HAYES Co Owner 443-629-2617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-02-11 |