| NPI | 1114446531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS MOTTON Program Director 410-444-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 261QM0801X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |