| NPI | 1578146809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZONA LORVENIA TEAL Program Director 410-908-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103TC1900X Psychologist, Counseling | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |