| NPI | 1083940647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KORDONSKI Clinic Director 410-420-7292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LGP3234) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2009-11-02 |