| NPI | 1821922337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARITA THOMPAS Licensing Consultant 443-929-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-06-10 |
| Last Update Date | 2026-06-10 |