| NPI | 1821720855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE HELLEN PETERSON Qi And B Illing 443-310-5494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |