| NPI | 1083912406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSAC C EVANS Manager 443-453-7746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care (Licence: MD 261QA0600) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2017-02-13 |