| NPI | 1104582659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ROGERS Partner 443-214-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |