| NPI | 1649593815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID COLLINS Administrative Director 443-523-2594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2010-03-02 |