| NPI | 1740798636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITU T BHAMBHANI Manager 410-777-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2023-09-19 |