| NPI | 1750005781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEELA MITCHELL Nurse Practitioner 443-300-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-11-04 |