| NPI | 1598415515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE 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 | 2022-03-24 |