| NPI | 1053991927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KENDALL Owner 443-275-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2024-04-07 |