| NPI | 1851124457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGNUS EZEANI CEO 443-220-1645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-12-06 |