| NPI | 1790329894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DURWOOD WHITTEN Licensed Psychologist 443-438-7863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2021-06-30 |