| NPI | 1134308828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. ALEX GREEN Clinical Director 410-715-6983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LC2308) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |