| NPI | 1992440242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN JOY DEVAUGHN Partner 443-484-6408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-04-02 |