| NPI | 1699130773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY BLACKSTOCK CEO 443-440-7018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |