| NPI | 1972173086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN RECK Manager 410-220-0720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2022-05-11 |