| NPI | 1649873613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DR LISA M GRESHAM-WILSON CEO 443-885-9406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |