| NPI | 1730655226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITEARA MICKEY Executive Director 443-447-1917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult | |
| 364SP0812X Clinical Nurse Specialist, Psych/Mental Health, Community | |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2024-03-05 |