| NPI | 1932876695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY INGADO Clinical Administrator 410-956-6800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP3300X Clinic/Center Pain | |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center Recovery Care | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2022-01-23 |