| NPI | 1104257799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN BRADLEY-POFF Program Administrator 410-225-7696 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 905047) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |