| NPI | 1770176513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEYINKA WINDAPO Adminstrator 443-251-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-06-15 |