| NPI | 1639716889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FULAI DIOM COO 443-213-8243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2025-06-24 |