| NPI | 1144955006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA NIKHINSON Vice President/COO 443-722-6492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2022-07-23 |
| Last Update Date | 2022-07-23 |