| NPI | 1053033126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCEE JONES Credentialing Director 410-824-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |