| NPI | 1104604099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KENDALL Chief Executive Officer 410-275-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 104100000X Social Worker | |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2024-01-17 |