| NPI | 1982302519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUEAD BURKE Owner 443-570-3075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 225C00000X Rehabilitation Counselor | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2023-02-22 |