| NPI | 1659136695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LIVELY COO 443-631-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |