| NPI | 1669192688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALAIKA LILLARD Owner 301-906-3654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |