| NPI | 1053192591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE ANTOINETTE DIGGINS Clinical Supervisor 443-602-6531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-10-10 |