| NPI | 1891478715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAN DOUGLASS CEO 443-810-5768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2024-08-12 |