| NPI | 1942924485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE D LEWIS Admin 443-845-4969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2022-09-28 |