| NPI | 1053718981 |
|---|---|
| Other Name | CCS MILLERSVILLE - MEDICAID FACILITY |
| Entity Type | Organization |
| Authorized Contact | MARK DAVID DONOVAN CEO 410-740-8066 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 905838) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2021-10-28 |