| NPI | 1649964347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ELLIOTT JOHNSON Owner 443-846-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-06-06 |