| NPI | 1639850316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BLACKSTON Director 410-517-7060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |