| NPI | 1578213500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE N MOUNTAIN Compliance Officer 443-204-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-06-09 |