| NPI | 1982006193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J BRIAN ROLLMAN Program Administrator 443-392-2049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC2014) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |