| NPI | 1689072803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BABAK IMANOEL President 410-871-3005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care (Licence: MD 102163) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2014-12-22 |