| NPI | 1629769088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON T DAVIS Owner 410-413-4108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-05-17 |