| NPI | 1851137368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOVID LAX Partner 410-409-3662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2024-07-03 |
| Last Update Date | 2024-07-03 |