| NPI | 1629743034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY INGADO Clinical Administrator 410-956-6800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 225C00000X Rehabilitation Counselor | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2022-01-23 |