| NPI | 1114050564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MILES Executive Director 410-426-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MD 10974207) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2007-07-31 |