| NPI | 1699358572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY WU Director 410-241-6317 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2022-12-07 |