| NPI | 1942924485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE D MARION Admin 443-673-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-09-28 |
| Last Update Date | 2025-09-11 |