| NPI | 1750930863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL RECK Manager 410-220-0780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2022-05-11 |