| NPI | 1114607637 |
|---|---|
| Doing Business As | BACK 2 LYFE OUTREACH SERVICES |
| Entity Type | Organization |
| Authorized Contact | LASHAUNA APRIL GRIER Program Director 443-286-7850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-07-27 |