| NPI | 1720762016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE MOUNTAIN Director Of Compliance 443-204-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |