| NPI | 1043714306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL NOTTINGHAM VP Finance/CFO 410-641-9602 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| 261QU0200X Clinic/Center, Urgent Care | |
| 208D00000X General Practice | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2021-11-17 |