| NPI | 1114510047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON HUBER Owner 443-415-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-11 |
| Last Update Date | 2021-02-11 |