| NPI | 1083933444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE BURR Director Of Professional Fees 410-706-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2025-10-14 |