| NPI | 1154851095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE GIVENS CEO 443-579-4659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-07-21 |