| NPI | 1104298355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVON MAGRUDER Executive Director 443-204-1134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 1700) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |