| NPI | 1134279284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF RICHARDSON CEO 410-453-9553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2008-09-23 |