| NPI | 1740833029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELE WILSON CEO 443-779-9901 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |