| NPI | 1619026432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT GARRETT BOWMAN Administrative Director 410-259-4985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: MD 11026) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-10-24 |