| NPI | 1942984513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE JAMES WILSON Clinical Director 443-271-2874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-07-17 |