| NPI | 1932061819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADEJAH MCDOUGALD Owner 443-422-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-11-28 |
| Last Update Date | 2025-11-28 |