| NPI | 1871060293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS EVANS CEO 443-386-7540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2018-10-24 |