| NPI | 1811626559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN JOY DEVAUGHN Partner 443-484-6408 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2024-04-02 |