| NPI | 1922706746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUHEAD BURKE Owner 443-570-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 225C00000X Rehabilitation Counselor | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-22 |