| NPI | 1710695101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGUFOR FUBE DIVINE President 410-870-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-11-26 |