| NPI | 1790145209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL LEWIS COOPER Chief Financial Officer 410-810-2468 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2022-01-21 |