| NPI | 1942944889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYIA GODLOCK Owner 410-262-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |