| NPI | 1114633617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH T COLLINS Co Owner 443-690-8029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-01-27 |
| Last Update Date | 2023-01-27 |