| NPI | 1083810774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M LYNN CLENDANIEL Billing Manager 410-228-3929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD D0050266) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-22 |