| NPI | 1144693540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA C COOK President/CEO 443-618-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD MH-1723) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MD MH-1723) |
| Enumeration Date | 2015-11-06 |
| Last Update Date | 2017-11-01 |