| NPI | 1669970331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN JOHNSON Executive Director 443-944-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2019-06-11 |