| NPI | 1588118137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE WEST WATSON Program Manager 410-467-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |