| NPI | 1568506004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL PRELL President 410-982-8364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MD 100982) |
| Additional Taxonomies | 261QM0801X (Licence: MD 904805) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2023-12-27 |