NPI | 1154744571 |
---|---|
Entity Type | Organization |
Authorized Contact | DIARI MARCUS BANIGO Director 410-900-3147 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 15059) |
Enumeration Date | 2014-01-22 |
Last Update Date | 2014-01-22 |