| NPI | 1073901278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN RICHARD BUTLER Vice President 443-661-1301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MD 1522) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2014-12-23 |