| NPI | 1982040077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION TRAVERS CEO/Clinical Director 443-859-8584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 251S00000X Community/Behavioral Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2023-03-15 |