| NPI | 1043895196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SMITH Program Director 410-304-6670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-05-14 |