| NPI | 1801114400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD LEE FOWLKES Addiction Counselor 410-735-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |